Nanomanaging healthcare

by Deane on August 8, 2011

In its 8/6/11 Editorial, the Albuquerque Journal quite rightly took the New Mexico legislature to task for considering taking sides in a dispute over the proper number of nurses in Christus St. Vincent Regional Medical Center in Santa Fe. The editor wrote, “Lawmakers have no business trying to micromanage your local hospital.”

What should the editor write when federal lawmakers tell you which pill you can take for your arthritis? What should you say when a Congressional panel decides how much your doctor’s skill and thus your health are worth? Finally (literally), what should we call it when federal bureaucrats decide whether you can have kidney dialysis or not, that is, whether you live or die?

When Congress does that, they are guilty of “nanomanaging” – a thousand times worse than micromanaging.

Congressional nanomanaging of healthcare harms us in two ways: it wastes our money and kills us, literally.

Start with the money. The figure touted for administrative cost of Medicare is 3%. You would therefore presume that 97% of Medicare money goes to patients as goods and services. Quite reasonable and quite wrong.

Hundreds of billions of Medicare dollars are wasted on regulatory compliance and oversight, remediation, duplication, and inefficiency. Neither the precise amount nor even a percentage is known because the government does not keep track of how much money IT consumes indirectly.

As for killing us, nanomanagement of healthcare by Congress forced Secretary of Defense Gates to choose between fighter jets and health benefits for military personnel. Nanomanagement and its handmaiden bureaucracy requires half, repeat half, of a doctor’s allotted time with a patient to do paperwork. Nanomanagement is heading toward denial of life-saving services because the “beast” (government) gets fed first: patients and providers get what is left over.

Just look at people dying in Canada waiting in line for “approved” care, or those dying in Great Britain because they are too old for NHS-approved treatments.

Lest you accuse me of exaggeration, each assertion above can be proven in newspapers and on TV: Canadian, British and C-SPAN.

H.R. 3590, also disingenuously called the Patient Protection and Affordable Health Care Act or “Obamacare,” is still unfolding. In essence, the legislation gave the Federal bureaucracy a blank check with which to regulate healthcare. A recent estimate puts the final page count for all of its regulations at 170,000. The U.S. tax code, not what we might call a model of simplicity, is 13,000 pages long.

Nanomanagement of healthcare produced a bill claiming to “reform” healthcare that could be 13 times longer than the entire tax code.

The bureaucracy that implements Congressional nanomanagement of healthcare (the system) consumes 40 cents out of every dollar spent by the U.S. supposedly for health care (the service).

It is extreme nanomanagement that found my hospital out of compliance because the books in my office were too tall. (It’s true. My imagination couldn’t make up something like that!)